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Friday, June 8, 2012

ABA Haters

Oh, the irony. An ABA fan writing about ABA haters.

Clearly from the title and content of my blog, I respect and
believe in ABA as a science. I started in this field working as an in-home therapy provider to 2 kids. I knew absolutely nothing about Autism or ABA at the time. Gradually, my knowledge grew, I received training, my experience grew, and so did my passion. I found the kids I worked with to be so smart and so capable, once you figured out how to teach them. I
quickly caught the ABA bug and became hooked on theLightbulb Moment. What's the lightbulb moment? I'm glad you asked.

The lightbulb moment is when you have been painstakingly trying to teach a skill to a child for days or even weeks, and then one day out of the blue something clicks and the child just gets it. The clouds part, angels sing, and you scare the child a little when you yell "That's RIGHT!" Its an amazing moment.

The more I learned about Autism the more I
wanted to learn. I probably drove my first few clients insane, because long
after my therapy sessions were over I would still be in their home asking
question after question about Autism. There was just so much to learn: sensory needs, supplements, advocacy, IEP's, funding for therapy, etc. Thankfully those parents were patient with me
and my constant questions.

As my love affair with ABA grew, our love bubble burst
as I started to become aware that there are people out there who don’t like
ABA.

Really? Yes, really.

There are even professionals, educators, and individuals who hate
ABA.

Hate it? Really? Yes, really.

Many of these people are adults with Autism, some who experienced ABA as children and some who did not. Their opinions about the
detriments of ABA are just as strong and vocal as mine about the benefits of
ABA. These individuals state that there's nothing wrong with being neurologically different and they don't need to be "fixed" or made normal by some ABA person.

My blog isn’t about bashing or putting down other therapy methods, or attacking people who don't agree with me. That's just not necessary.

I
think the best decisions are informed decisions. Don’t become an ABA hater based on outdated or distorted information you read on the internet. There’s
a lot of misinformation out there, and many untruths about what ABA is -- far too
many for me to address here. So I will tackle a few.

Reasons Why People Hate ABA

History of ABA- I
referenced this briefly in my post on Punishment,
but ABA had an ominous start. If you read the research on how ABA was originally done it was punishment heavy. Children who didn’t respond correctly were
slapped, spanked, yelled at, or received electric shocks. As the field advanced, professionals realized that
reinforcement is much more effective than punishment. ABA as a field became reinforcement based, and created rigorous ethical standards for ABA professionals. Some ABA haters incorrectly believe that ABA therapy still looks the way it did decades ago, which is just not accurate.

Think ABA is Just Discrete Trial Teaching- I have had new clients say to me they don’t want their child to
be drilled 50 times to say “banana”, because cousin so-and-so told them that’s
what ABA is. ABA is a broad term that covers a wide range of therapeutic
approaches. Depending on the needs and learning style of the child, there are many
ways to implement ABA therapy: Verbal Behavior,
Natural Environment Teaching, Incidental Teaching, Pivotal Response Training, etc. Every one of these methods is
unique, and has advantages and disadvantages depending on the specific treatment goals. If you don't want your child to be intensively drilled in a very structured manner, then don't use a discrete trial approach. I love discrete trial; its extremely effective...but it is not appropriate for every client.

"I just hate the idea of behavior therapy/ABA Therapy is an unnatural treatment!"- So here is the problem with this criticism: the science of ABA is all around you, all the time, whether you sign up for therapy or not. Behavior contingencies explain how you learned to answer a ringing telephone, why you say sorry when you offend someone, and why you reduce your speed when you drive past a police car. ABA is based in conditioning, which to put it simply is the fact that we learn what to do/what not to do by what consequences follow our behavior. All ABA therapy does is apply this science and research to create individualized strategies, that are taught in a precise way. So unless you plan to completely stop behaving (hint: that's impossible), then every single day you are adjusting your own behavior based on the consequences to your behavior.

Frauds/Shysters Exploit Families- Another criticism is that
the field of ABA is full of amateurs claiming be experts. The national certification for ABA professionals has been
around since 1998. Before that time, anyone who could
convince people of it could label themselves an Autism Expert or Consultant. Accountability was very low. The ABA
field established board certification specifically to protect the public from
amateurs calling themselves experts, and to raise the requirements of working
in this field. The BCBA certification process is difficult and lengthy, and in some states licensure is required on top of certification. My response to this criticism would be to look for credentialed and experienced professionals, and be very leery of programs with "pseudo-ABA" (e.g. "Behavior Tech", "Autism Consultant") staff and not a single certified individual supervising them.

ABA Creates Robots- You've probably heard this criticism before: ABA creates robotic children incapable
of spontaneous thought who can only spit out memorized responses like a trained seal. Sound harsh? ABA haters make much harsher statements than that, and actually believe them to be true. Some ABA programs do start off with rote memorization.
That’s how many of us initially learned skills. How did you learn the
multiplication tables? It was likely by memorizing it. At some point someone
helped you move from memorizing to actually learning. That’s what a quality ABA
program does. When I teach a child to vocally imitate, initially they will
sound slightly robotic and I reinforce them every single time they emit
a sound. Over time they begin to learn more naturally, I provide less
reinforcement, and I teach them to use a natural speaking tone. If your
child has a stilted/artificial way of speaking and can only respond to a
question if it is asked in a precise way, then they may be in a poor quality
ABA program. This resource should help you evaluate if you are receiving quality intervention or not.

Autism is a Medical Disorder and Should be Treated Medically – There is some truth to this criticism. I do believe that Autism affects the body and brain in many ways. The child can have toxic yeast, allergies, comorbidity (such as Autism & ADHD), etc.
Each of those issues may require a separate treatment. I’m not an OT, so I
wouldn’t try and design an OT program. I work in the domain of behavior. It’s better to think of Autism treatment as a package deal.
Depending on your child your treatment package may be “Speech Therapy-Social Group-Private School”.
Or your package may include “ABA therapy-Counseling-Homeschooling”. It will vary depending on
the child and their needs. The reason why so many
treatment packages include ABA is that ABA as a treatment covers many skill domains at once, and it focuses intensively on behavior. Many parents really need that behavioral help.

ABA Therapy is TOO
intensive/A 3 year old Should be Outside Playing! – The problem with this
criticism is this is a decision for the parents. "Parent shaming" is not ok, as families struggle to make the best choices for their children that they can. Some parents want to start therapy as intensively as
possible while the child is young. Other
parents feel they want their child to enjoy being a child and not just shuffle
from one therapy session to the next. I don’t make parenting decisions, I make
clinical programming decisions. I must add that for anyone who thinks children should be
outside playing instead of receiving needed intervention, did you know that
some of these children don’t play? When I first meet a new client they often spend their days engaging in problem behavior, trying to escape the home, or harming themselves or others. For those children,
I'd say their parents are much more interested in teaching critical life skills than being told their child is getting too much therapy.

ABA is about Erasing Autistic Traits and Forcing "Normal" Traits- This is a super common ABA myth. I definitely believe that neuro -diversity should be appreciated, after all some individuals with Autism have become great authors, speakers, or inventors due in part to their Autistic traits.The goal of a quality ABA program is
not to erase the Autism and make the child “Normal”. If any so-called professional tells you that is the goal of treatment, then you are not dealing with an ethical professional. Normal is a relative term that can mean many things to many people. The goal of treatment should be to teach critical life skills, and remove barriers to instruction....that's it. ABA therapy is about causing beneficial changes to help improve quality of life. For example: Talking. Using a toilet. Attending to a Teacher. Accepting changes to the daily schedule.

Many of these criticisms are likely true for poor quality
ABA programs, or programs lacking BCBA supervision.
It’s unfortunate, but some people have bad experiences with an agency, company,
or therapist and they blame the entire field of ABA for it. Believe me, I understand. I have had bad experiences as an employee of some agencies or companies. That didn't dissuade me from the passion I have for this field. It actually propelled me further, to be the change I wanted to see. If you come across an ill -mannered and rude doctor, do you then hate the entire field of medicine? Do you stop seeking needed medical treatment??

Please don’t confuse
the methods of an unethical or unprofessional ABA practitioner with the vast science
of ABA.

I like your style! I like telling like it is. As a parent I would like to add "Buyer beware" as much as there are good people doing great things there are average to below average people doing horrible things. People come out of the programs with certificates but it only means they passed a test. Sorry but there are very bad students out there that can pass test but not be able to solve a behavior problem and are too proud or stubborn to get or ask for help anywhere else. Just know you can go through a lot of BCBA's but that does not mean just because they have those letters they are any good. The same goes for all "professionals" with letters in their name.

I completely agree, it is important to properly evaluate any professional beyond their experience/expertise to look at their professional manner, punctuality, attention to detail, flexibility, etc. If the individual comes across as rude, stubborn, condescending, etc., those are really bad signs.